Why you may not be losing weight on the keto diet

• Most people who do the keto diet will lose weight, but you have to follow it strictly and be in a calorie deficit to make it work.
• Over time, you may hit a "keto plateau" where you will stop losing weight, even while following the same diet.
• Even if you don't lose weight, a slightly higher number on the scale may not always be a bad sign if you are gaining muscle.
• This article was reviewed by Samantha Cassetty, MS, RD, nutrition and wellness expert with a private practice based in New York City.

The keto diet is a popular way to lose weight and improve health. But not everyone loses weight on keto, and some stop losing weight after a few months.

If you aren't meeting your weight goals on the ketogenic diet, you may need to make some adjustments or talk with a registered dietitian. Here are some reasons why you might not be losing weight on keto.

You're not reaching ketosis

The main purpose of the ketogenic diet is to send your body into ketosis. Ketosis is a state where your metabolism shifts from burning carbohydrates for fuel to fat cells, instead.

However, it can take a lot of careful planning to put your body into ketosis. And it won't happen immediately. It can take anywhere from two to seven days of extreme carb restriction to reach ketosis.

You can check to see if you are really in ketosis using at-home urine test strips. These strips detect ketones, substances your liver creates when processing fat.

However, being in ketosis is not going to make you lose weight if you are still taking in too many calories, says Scott Keatley, RD, a dietitian at Keatley Medical Nutrition Therapy.

You're eating too many calories

Losing weight on the keto diet is like losing weight on any diet — you need to burn more calories in the day than you consume.

The restriction does not need to be extreme, but you should be at a caloric deficit.

Being in ketosis makes this a little easier since — with the right foods — it can reduce your appetite so you're less hungry and therefore, less likely to overeat.

Some foods to eat on keto that will help you feel full are:

• Fiber-rich, low-carb vegetables — like leafy greens, broccoli, and asparagus
• Lean, protein-packed meat like seafood and poultry.
• Healthy fatty foods like avocados, nuts, and seeds.

However, if you're still having trouble controlling your caloric intake, here are some tips:

1. Replace any sugary drinks you might have with flavored water.
2. Measure out snacks beforehand so you don't unconsciously consume too much.
3. Track your calories with one of Insider Review's best weight loss apps.

You're not eating enough calories

If you restrict calories too much — to less than 1,200 per day for the average adult — this can also slow your weight loss goals. Because when you don't eat enough it can send your body into starvation mode, where your metabolism slows down and you may stop losing weight.

You're too stressed

Numerous studies indicate a strong link between stress and obesity. Part of the reason could be related to the fact that stress increases levels of the stress hormone cortisol in your body, which leads to enhanced appetite and potentially overeating and subsequent weight gain.

Some simple ways to relieve stress include:

1. Exercising regularly
2. Getting more sleep
3. Connecting with loved ones

You're not active enough

The Department of Health and Human Services recommends adults complete at least 150-300 minutes of moderate exercise per week. Physical activity is important for many reasons, including maintaining a healthy weight.

Regular exercise can also help reduce stress levels, boosting your chances of appetite control and weight loss. Some tips to maintaining a regular workout routine include:

1. Choose a workout regimen you enjoy.
2. Find a workout partner(s) to hold you accountable.
3. Make long-term goals to work toward.

You've reached the keto plateau

Even if you are keeping your metabolism up, your weight loss may still slow down over time. As you cut calories and lose weight, your body will adapt to the change and start needing fewer calories to keep itself going, says Keatley. In other words, people tend to hit a weight loss plateau.

However, Keatley says that you should not use the scale as your only measure of progress. Lean muscle is denser than fat, so burning fat and building muscle can actually lead to a slight weight increase. "The scale may freak you out when the change happening is positive," Keatley says.

You have an underlying medical condition

There are certain medical conditions that are associated with weight gain, making it exceptionally difficult to lose weight. Many of these conditions are hormonal disorders like Polycystic ovary syndrome (PCOS), diabetes, Cushing's syndrome, and hypothyroidism.

The bottom line

Cutting carbs on the keto diet can lead to rapid weight loss. But if you're not losing weight, make sure you're in ketosis, not eating too many calories, and are controlling your stress levels.

If you're considering trying the keto diet to lose weight, Keatley says, "I would advise anyone thinking of a keto diet to talk to their doctor and a dietitian before, during, and after."

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